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Intro and request for advice
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Seabird Offline

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Posts: 39
Joined: Jan 2015

Machine: ResMed Airsense 10
Mask Type: Nasal pillows
Mask Make & Model: P10
Humidifier: ResMed
CPAP Pressure: 7
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #1
Intro and request for advice
Hi, I'm a new member of the board. Quick history - I was diagnosed with OSA about 6 months ago with an AHI of 20. I got a CPAP machine and I have been using it consistently.

Initially I had a lot of issues. I was extremely tired after sleeping 10-11 hours a night. I would always take my mask off after 6 hours or so and go back to sleep. I also had a lot of leaks at this point. I started with the P10 pillows and pressures of 5-15. Went to the doctor and he adjusted the pressure to a constant 7 and recommended that I use a chinstrap to help with the leaks. The lower pressure seems to help somewhat.

I tried a few different chinstraps but I was still getting leaks. Then I tried a nasal mask - the Eson. I was getting a lot of leaks with that so I tried the RemZzzs liners but they didn't help. Then I tried the mask with the chinstrap, which was a crazy amount of headgear. That didn't really help with the leaks either.

Talked to the doc again and he says I should try another mask. I met with the DME and he had me try the Swift, which didn't fit and the F10 FFM. I was a bit concerned with the F10 moving when I moved around but I thought it was worth a try. It ended up leaking constantly. I am actually not able to move it into a position where it doesn't leak, even while awake. Back to square one.

I'm trying to figure out what to do next. I prefer the pillows but it always ends up moving at some point and waking me up with a leak. My AHI is good but I am not feeling at all rested, most likely because of the leaks. Neither my DME or my doctor is being very helpful - maybe try another doctor?
02-23-2015 06:08 PM
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justMongo Offline

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Posts: 3,853
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #2
RE: Intro and request for advice
Finding which mask suits you is perhaps the biggest challenge to getting effective and comfortable CPAP therapy. Everyone is different; and what works for one person does not necessarily work for another. And, people will have many recommendations; but in the end, it's up to you to find what works for you.

Any mask that results in larger leaks will not deliver effective therapy. Sometimes people give up on a certain mask; when the problem is that they are not wearing it properly.

Any mask that's not a full-face requires you to keep your mouth closed. Chins straps work for some people.
You like pillows, but you move and the mask is displaced causing a leak. Perhaps you need to think about how you are arranging the hose.
Some people rig a way to hang the hose such that movement minimizes mask displacement.

Kindest regards,

Mongo

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
02-23-2015 06:58 PM
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trish6hundred Offline

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Posts: 6,449
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #3
RE: Intro and request for advice
Hi Seabird,
WELCOME! to the forum.!
CPAP therapy can take some getting used to, and the mask is the hardest part of the whole thing, so don't be shy about asking to try as many masks as you need 'til you find the one that works for you.
Hang in there for more responses to your post and much success to you with your CPAP therapy and finding a mask.

trish6hundred
02-23-2015 07:15 PM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #4
RE: Intro and request for advice
I am curious as to what chin strap you tried. I had a great chin strap and when I ordered a replacement the DME sent me a chin strap that hardly had any material to it and what material there was, was weak at best and there was no cup for my chin and no way was that chin strap going to do anything but cover up a little bit of my face. So, maybe you could stick with the pillows or nasal mask, which ever you prefer, and then get a better chin strap and see if that helps. I used a chin strap with a nasal mask for a month or so and then I didn't need to use it anymore because my mouth stayed shut when I was sleeping. YMMV
02-23-2015 07:52 PM
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OpalRose Offline

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Posts: 3,181
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #5
RE: Intro and request for advice
(02-23-2015 06:08 PM)Seabird Wrote:  Hi, I'm a new member of the board. Quick history - I was diagnosed with OSA about 6 months ago with an AHI of 20. I got a CPAP machine and I have been using it consistently.

Initially I had a lot of issues. I was extremely tired after sleeping 10-11 hours a night. I would always take my mask off after 6 hours or so and go back to sleep. I also had a lot of leaks at this point. I started with the P10 pillows and pressures of 5-15. Went to the doctor and he adjusted the pressure to a constant 7 and recommended that I use a chinstrap to help with the leaks. The lower pressure seems to help somewhat.

I tried a few different chinstraps but I was still getting leaks. Then I tried a nasal mask - the Eson. I was getting a lot of leaks with that so I tried the RemZzzs liners but they didn't help. Then I tried the mask with the chinstrap, which was a crazy amount of headgear. That didn't really help with the leaks either.

Talked to the doc again and he says I should try another mask. I met with the DME and he had me try the Swift, which didn't fit and the F10 FFM. I was a bit concerned with the F10 moving when I moved around but I thought it was worth a try. It ended up leaking constantly. I am actually not able to move it into a position where it doesn't leak, even while awake. Back to square one.

I'm trying to figure out what to do next. I prefer the pillows but it always ends up moving at some point and waking me up with a leak. My AHI is good but I am not feeling at all rested, most likely because of the leaks. Neither my DME or my doctor is being very helpful - maybe try another doctor?

Welcome Seabird,
The nasal pillow mask should give you the least amount of problems. I'm wondering how you sleep...on your side, stomach? Do you toss and turn in your sleep?
All of this makes a difference. If you prefer the nasal pillows I wouldn't give up on it.
Make sure you change the nasal pillows often. Insurance usually pays for 2 per month. It sounds excessive, but it is not. They wear out pretty fast, get soft, and then they don't fit as well and will cause leaks.
Your DME should help you with this. I haven't heard of a Doctor yet that cares about what mask you are wearing.
Sleep-on-pillow
OpalRose

OpalRose
02-23-2015 07:58 PM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #6
RE: Intro and request for advice
I'd suggest you give the P10's another chance.

Put on the chinstrap first, but make sure you don't use it too tightly. If you use it too tightly, then you'll end up clinching your jaw and during the night your lips will part as you are grimace in pain, causing a leak. The chinstrap should simply "encourage" the jaw to stay forward, not force anything. You should still be able to open your mouth and even talk if you need too.

Now put on the P10's, but use one size larger pillow than you think you should need to use. So for instance if you think you need a medium, use a large. The straps should fit snugly on your head, but not so snug as to suck your nose into your brains. If the straps are too loose, you can cut them, then put them back together using a safety pin in order to get a tighter fit. If they are too tight, you should be able to stretch them then put them on.

Finally, you can apply a bit of HPA Lanolin to your nostrils before you put on the P10. That will allow for a better seal as well. HPA Lanolin is available in the baby department at your local drugstore.

and finally, finally.... Get us some results from Sleepyhead so we can see just exactly what sort of ahi and leak experience you are having.

Oh... and by the way: It is true as Mongo says, that everyone is different. Except for me. I'm not different. I'm the same.
02-23-2015 08:26 PM
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TyroneShoes Offline

Preferred Members-2

Posts: 505
Joined: Oct 2014

Machine: Resmed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10
Humidifier: Resmed H5i
CPAP Pressure: 10-14
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location:

Post: #7
RE: Intro and request for advice
One thing my DME tech DID NOT tell me, is that if you "size" the pillows without the blower on, you will likely settle for the one that "feels right". But when the blower is on, it inflates the pillows against the nose making them tighter, which means you may have the mask too tight, and you may be using a size that is too small. Check the fit with the blower on, laying down.

If you are someone who (not assuming that you are) subconsciously digs your face into the pillow when asleep, that can certainly affect the mask fit. There is a device that was mentioned here (someone else please supply the name if you can) that is a pillow mask attached to a mouth guard, with a mechanical adjustment. The dental device part can be helpful in jaw placement, but having it attached firmly to the pillow mask keeps that from moving as well, so it may be just the ticket for those who have leak issues related to head movement during sleep.
02-23-2015 08:41 PM
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OpalRose Offline

Monitors

Posts: 3,181
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #8
RE: Intro and request for advice
(02-23-2015 08:41 PM)TyroneShoes Wrote:  One thing my DME tech DID NOT tell me, is that if you "size" the pillows without the blower on, you will likely settle for the one that "feels right". But when the blower is on, it inflates the pillows against the nose making them tighter, which means you may have the mask too tight, and you may be using a size that is too small. Check the fit with the blower on, laying down.

If you are someone who (not assuming that you are) subconsciously digs your face into the pillow when asleep, that can certainly affect the mask fit. There is a device that was mentioned here (someone else please supply the name if you can) that is a pillow mask attached to a mouth guard, with a mechanical adjustment. The dental device part can be helpful in jaw placement, but having it attached firmly to the pillow mask keeps that from moving as well, so it may be just the ticket for those who have leak issues related to head movement during slehep.

I believe it is called the TAP PAP mask.

OpalRose
02-23-2015 10:26 PM
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Seabird Offline

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Posts: 39
Joined: Jan 2015

Machine: ResMed Airsense 10
Mask Type: Nasal pillows
Mask Make & Model: P10
Humidifier: ResMed
CPAP Pressure: 7
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #9
RE: Intro and request for advice
Yes, I think the hose may be pulling on the mask when I move around.

(02-23-2015 06:58 PM)justMongo Wrote:  Finding which mask suits you is perhaps the biggest challenge to getting effective and comfortable CPAP therapy. Everyone is different; and what works for one person does not necessarily work for another. And, people will have many recommendations; but in the end, it's up to you to find what works for you.

Any mask that results in larger leaks will not deliver effective therapy. Sometimes people give up on a certain mask; when the problem is that they are not wearing it properly.

Any mask that's not a full-face requires you to keep your mouth closed. Chins straps work for some people.
You like pillows, but you move and the mask is displaced causing a leak. Perhaps you need to think about how you are arranging the hose.
Some people rig a way to hang the hose such that movement minimizes mask displacement.

Kindest regards,

Mongo


Thanks. Yes, I guess I will just have to keep trying.

(02-23-2015 07:15 PM)trish6hundred Wrote:  Hi Seabird,
WELCOME! to the forum.!
CPAP therapy can take some getting used to, and the mask is the hardest part of the whole thing, so don't be shy about asking to try as many masks as you need 'til you find the one that works for you.
Hang in there for more responses to your post and much success to you with your CPAP therapy and finding a mask.
(This post was last modified: 02-23-2015 11:40 PM by Seabird.)
02-23-2015 11:39 PM
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Seabird Offline

Preferred Members

Posts: 39
Joined: Jan 2015

Machine: ResMed Airsense 10
Mask Type: Nasal pillows
Mask Make & Model: P10
Humidifier: ResMed
CPAP Pressure: 7
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #10
RE: Intro and request for advice
First I tried a generic chin strap, which didn't work at all. The issue was that it held my ears in a strange position which caused pain. Then I tried the "ruby" chinstrap.

That one is much more comfortable and adjustable. It seems to work well. I believe my issue is still that the pillows are leaking. My doctor's theory was that the chinstrap would keep the mask's headgear from moving around as much but that doesn't seem to be the case.

(02-23-2015 07:52 PM)me50 Wrote:  I am curious as to what chin strap you tried. I had a great chin strap and when I ordered a replacement the DME sent me a chin strap that hardly had any material to it and what material there was, was weak at best and there was no cup for my chin and no way was that chin strap going to do anything but cover up a little bit of my face. So, maybe you could stick with the pillows or nasal mask, which ever you prefer, and then get a better chin strap and see if that helps. I used a chin strap with a nasal mask for a month or so and then I didn't need to use it anymore because my mouth stayed shut when I was sleeping. YMMV


I usually sleep on my back, but I wake up sleeping on my side. I'm learning that I toss and turn more than I thought I did. I have been replacing the pillows, but yeah that is a good point. I agree that my DME should help me, but that's the issue. Smile

(02-23-2015 07:58 PM)OpalRose Wrote:  Welcome Seabird,
The nasal pillow mask should give you the least amount of problems. I'm wondering how you sleep...on your side, stomach? Do you toss and turn in your sleep?
All of this makes a difference. If you prefer the nasal pillows I wouldn't give up on it.
Make sure you change the nasal pillows often. Insurance usually pays for 2 per month. It sounds excessive, but it is not. They wear out pretty fast, get soft, and then they don't fit as well and will cause leaks.
Your DME should help you with this. I haven't heard of a Doctor yet that cares about what mask you are wearing.
Sleep-on-pillow
OpalRose
(This post was last modified: 02-23-2015 11:51 PM by Seabird.)
02-23-2015 11:48 PM
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